US20040004105A1 - Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces - Google Patents
Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces Download PDFInfo
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- US20040004105A1 US20040004105A1 US10/411,686 US41168603A US2004004105A1 US 20040004105 A1 US20040004105 A1 US 20040004105A1 US 41168603 A US41168603 A US 41168603A US 2004004105 A1 US2004004105 A1 US 2004004105A1
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- anvil
- staple cartridge
- working surface
- surgical stapling
- staple
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
- A61B17/105—Wound clamp magazines
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/2812—Surgical forceps with a single pivotal connection
- A61B17/282—Jaws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07271—Stapler heads characterised by its cartridge
Abstract
Description
- The present application claims priority to U.S. Provisional Patent Application Serial No. 60/372,356 filed Apr. 11, 2002, the entire contents of which are incorporated herein by reference.
- 1. Technical Field
- The present disclosure relates to surgical stapling apparatus, and more particularly to surgical stapling apparatus having complementarily shaped staple anvil and staple cartridge surfaces.
- 2. Background of Related Art
- There are several known types of surgical staplers specifically adapted for use in various procedures such as end-to-end anastomosis; circular end-to-end anastomosis; gastrointestinal anastomosis; endoscopic gastrointestinal anastomosis; and transverse anastomosis specific examples of staplers for these various procedures are for example, EEA™, CEEA™, GIA™, EndoGIA™, and TA™ available from United States Surgical a division of Tyco Health-Care Group, LP, Norwalk, Conn., with each stapler including an anvil which is adjustably approximated relative a staple cartridge. The staple cartridge typically has at least two laterally spaced rows of staples, which depending on the particular stapler may be arranged in a linear or non-linear fashion. The anvil includes staple deforming depressions formed therein which staple deforming depressions are aligned with the rows of staples in the cartridge. In use, each of the surgical staplers involves the gripping of tissue to be fastened, the ejecting of individual staples, the forcing of staples through the gripped tissue and the closing of the staples against the staple deforming depressions formed in the anvil of the stapler.
- A continuing need exists for improved surgical stapling apparatus having means for enhancing alignment of the anvil with the staple cartridge in one of, preferably in both, a transverse and longitudinal direction during or upon approximation or mating of the anvil with the staple cartridge with tissue or material to be stapled therebetween.
- The present disclosure relates to surgical stapling apparatus having a shaped anvil and shaped cartridge.
- According to one aspect of the present disclosure, a surgical stapling apparatus is provided including an anvil having a working surface with a plurality of staple forming depressions formed therein, the working surface of the anvil having a non-planar cross-sectional shape, and a staple cartridge having a working surface in juxtaposition to the working surface of the anvil and including a plurality of staple retention slots formed therein, the working surface of the staple cartridge having a shape which complements the shape of the working surface of the anvil, wherein when the anvil and staple cartridge are approximated with one another with tissue therebetween, at least a portion of the working surface of the anvil cooperates with at least a portion of the working surface of the staple cartridge to enhance alignment of the plurality of staple forming depressions with the plurality of staple retention slots.
- It is envisioned that the working surface of the staple cartridge includes a pair of inclined wall portions extending longitudinally along a length thereof, and wherein the working surface of the anvil includes a pair of inclined wall portions extending along a length thereof and complementing the pair of inclined wall portions of the working surface of the staple cartridge. Each inclined wall portion of the staple cartridge has an inner longitudinal edge and an outer longitudinal edge, and the inner longitudinal edges are parallel and spaced apart from one another, recessed with respect to a plane defined by the outer longitudinal edges, and defining a knife track.
- It is envisioned that the staple cartridge includes first and second side walls, parallel to and spaced apart from one another, and wherein a first inclined wall portion of the staple cartridge extends from the first side wall of the staple cartridge at an angle which is less than 90° relative to the first side wall and a second inclined wall portion of the staple cartridge extends from the second side wall of the staple cartridge at an angle which is less than 90° relative to the second side wall. Each inclined wall portion of the anvil has an inner longitudinal edge and an outer longitudinal edge, and the inner longitudinal edges are parallel and spaced apart from each other, recessed with respect to a plane defined by the outer longitudinal edges, and defining a knife track.
- It is envisioned that the anvil includes first and second side walls, parallel to and spread apart from one another, and wherein a first inclined wall portion of the anvil extends from the first side wall of the anvil at an angle which is greater than 90° and less than 180° relative to the first side wall and a second inclined wall portion of the staple cartridge extends from the second side wall of the anvil at an angle which is greater than 90° and less than 180° relative to the second side wall.
- The working surface of the staple cartridge can have an arcuate shape in a direction transverse to a longitudinal axis thereof, and wherein the working surface of the anvil has a shape which is complementary to the arcuate surface of the staple cartridge. It is envisioned that the working surface of the staple cartridge is one of concave and convex in the transverse direction.
- It is contemplated that at least one of the staple cartridge and the anvil includes a longitudinally running channel extending along the length thereof.
- In one embodiment it is envisioned that the working surfaces of the anvil and the staple cartridge are annular. The staple cartridge can include an upstanding annular side wall extending from at least one of an inner and outer terminal edge of the surface of the staple cartridge and inclined at an obtuse angle relative thereto. Alternatively, the staple cartridge can include an upstanding annular side wall extending from each of an inner edge and an outer edge of the surface of the staple cartridge, wherein the annular side walls are inclined at an obtuse angle relative to the surface of the surgical staple cartridge. The angle of inclination of the annular side walls is greater than 90° and less than 180°.
- It is envisioned that the working surface of the anvil can have an arcuate shape in a radial direction and wherein the working surface of the staple cartridge has a shape that is complementary to that of the working surface of the anvil. Preferably, the working surface of the anvil, in radial transverse cross-section, is one of convex and concave.
- It is contemplated that the working surface of the anvil is angled such that an inner terminal edge thereof is depressed relative to an outer terminal edge thereof. Alternatively, it is contemplated that the working surface of the anvil is angled such that an inner terminal edge thereof is elevated relative to an outer terminal edge thereof.
- It is envisioned that the working surface of the anvil is provided with at least one longitudinally oriented arcuate recess formed therein and wherein the working surface of the staple cartridge is provided with at lease one projection extending therefrom, wherein the at least one projection complements the at least one recess to longitudinally align the anvil and staple cartridge when approximated with one another.
- According to another aspect of the present disclosure, a surgical stapling apparatus is provided which includes an anvil having a working surface with a shaped topography, and a staple cartridge having a working surface in juxtaposition with the anvil, the working surface of the staple cartridge having a shaped topography which is complementary to the shaped topography of the working surface of the shaped anvil, such that when the anvil and the staple cartridge are approximated with one another with tissue therebetween, cooperation of at least a portion of the working surface of the anvil with at least a portion of the working surface of the staple cartridge enhances alignment of the staple cartridge and the anvil in at least one of transverse and longitudinal directions.
- It is envisioned that either the anvil, the staple cartridge or both the anvil and the staple cartridge can have an arcuate cross-sectional profile or a V-shaped cross-sectional profile. It is further envisioned that at least one of the anvil and the staple cartridge has a topographical surface undulating in at least one of a transverse and a longitudinal direction.
- In one embodiment, at least one of the anvil and staple cartridge defines a longitudinal axis. The working surface of the anvil is angled with respect to the longitudinal axis of the anvil. The working surface of the anvil can be angled to either decline or incline from the distal end to the proximal end of the anvil. It is envisioned that the anvil can have at least one of a V-shaped and arcuate transverse cross-sectional profile.
- In another embodiment, the surgical stapling apparatus defines a longitudinal axis. It is thus contemplated that the working surface of each of the anvil and staple cartridge is angled relative to the longitudinal axis of the surgical stapling apparatus. The working surface of the anvil can be angled to either decline or incline from the distal end to the proximal end of the anvil. It is envisioned that the anvil can have at least one of a V-shaped and arcuate transverse cross-sectional profile.
- In accordance with another aspect of the present disclosure, a surgical stapling apparatus is provided including an anvil having a working surface with a plurality of staple forming depressions formed therein, the working surface of the anvil having a non-planar cross-sectional shape, and a staple cartridge having a working surface in juxtaposition to the working surface of the anvil and including a plurality of staple retention slots formed therein. The working surface of the staple cartridge has a shape which complements the shape of the working surface of the anvil, such that as the anvil and staple cartridge are approximated relative to one another with tissue therebetween, the working surface of the anvil cooperates with the working surface of the staple cartridge to help align the plurality of staple forming depressions with the plurality of staple retention slots.
- In yet another aspect of the present disclosure, a surgical stapling apparatus is provided including an anvil having a working surface with a shaped topography, and a staple cartridge having a working surface in juxtaposition with the anvil. The working surface of the staple cartridge has a shaped topography which is complementary to the shaped topography of the working surface of the shaped anvil, such that as the anvil and the staple cartridge are approximated with one another with tissue therebetween, cooperation of at least a portion of the working surface of the anvil with at least a portion of the working surface of the staple cartridge enhances alignment of the staple cartridge and the anvil in at least one of a transverse and longitudinal direction.
- It is envisioned that, when approximated, the anvil and cartridge of the surgical stapling apparatus can be clamped.
- These objects together with other objects of the disclosure, along with the various features of novelty which characterize the disclosure, are pointed out with particularity in the claims annexed to and forming a part of the disclosure.
- By way of example only, preferred embodiments of the disclosure will be described with reference to the accompanying drawings, in which:
- FIG. 1 is a perspective view of one illustrative embodiment of a linear surgical stapling apparatus constructed in accordance with the present disclosure;
- FIG. 2A is an enlarged perspective view of one embodiment of a linear staple cartridge for a surgical stapling apparatus such as the apparatus shown in FIG. 1;
- FIG. 2B is an enlarged perspective view of a staple anvil for use with the staple cartridge of FIG. 2A;
- FIG. 3 is a schematic enlarged cross-sectional view of the approximated staple cartridge and staple anvil of FIGS. 2A and 2B;
- FIG. 4A is an enlarged perspective view of an alternative illustrative embodiment of a staple cartridge for a linear surgical stapling apparatus;
- FIG. 4B is an enlarged perspective view of an alternative illustrative embodiment of a staple anvil for use with the staple cartridge of FIG. 4A;
- FIG. 5 is an enlarged cross-sectional view of the approximated staple cartridge and staple anvil of FIGS. 4A and 4B;
- FIG. 6 is a perspective view of an alternative surgical stapling apparatus including a staple cartridge and staple anvil in accordance with the present disclosure;
- FIG. 7 is an enlarged exploded perspective view of a tool assembly for the surgical stapling apparatus shown in FIG. 6 including the staple cartridge and staple anvil in accordance with the present disclosure;
- FIG. 7A is a distal end view of the staple anvil of FIG. 7;
- FIG. 7B is a cross-sectional view of the staple cartridge of FIG. 7 as taken along7B-7B of FIG. 7;
- FIG. 8 is a perspective view of an alternative surgical stapling apparatus including a staple cartridge and staple anvil in accordance with the present disclosure;
- FIG. 9A is a plan view of the staple anvil of the surgical stapling apparatus of FIG. 8;
- FIG. 9B is a plan view of the staple cartridge of the surgical stapling apparatus of FIG. 8;
- FIG. 10 is a perspective view of an alternative surgical stapling apparatus including a staple cartridge and staple anvil in accordance with the present disclosure;
- FIG. 11A is an exploded perspective view of the staple cartridge and staple anvil working surfaces in accordance with the present disclosure;
- FIG. 11B is a perspective view of the staple cartridge of FIG. 11A;
- FIG. 11C is a perspective view of the staple anvil of FIG. 11A;
- FIG. 12A is a schematic enlarged cross-sectional view of the staple cartridge and staple anvil working surfaces taken along
section line 12A-12A of FIG. 11A; - FIG. 12B is a schematic enlarged cross-sectional view of working surfaces of an alternative embodiment of a staple cartridge and staple anvil;
- FIG. 12C is a schematic enlarged cross-sectional view of working surfaces of an alternative embodiment of a staple cartridge and staple anvil;
- FIG. 12D is a schematic enlarged cross-sectional view of working surfaces of an alternative embodiment of the staple cartridge and staple anvil of FIG. 12C;
- FIG. 12E is a schematic enlarged cross-sectional view of working surfaces of an alternative embodiment of a staple cartridge and staple anvil;
- FIG. 12F is a schematic enlarged cross-sectional view of working surfaces of an alternative embodiment of the staple cartridge and staple anvil of FIG. 12E;
- FIG. 13 is a schematic enlarged side elevational view of a portion of working surfaces of a staple cartridge and staple anvil according to a further alternative embodiment of the present disclosure;
- FIG. 14 is a schematic enlarged side elevational view of a portion of an approximated staple cartridge and staple anvil according to yet another alternative embodiment of the present disclosure;
- FIG. 15 is a schematic enlarged side elevational view of a portion of an approximated staple cartridge and staple anvil according to still another alternative embodiment of the present disclosure; and
- FIGS. 16 and 17 are schematic enlarged side elevational views of portions of the approximated staple cartridge and staple anvil according other alternative embodiments of the present disclosure.
- Preferred embodiments of the presently disclosed surgical stapling apparatus will now be described in detail with reference to the drawing figures wherein like reference numerals identify similar or identical elements. In the drawings and in the description which follows, the term “proximal”, as is traditional, will refer to the end of the surgical apparatus which is closest to the operator, while the term “distal” will refer to the end of the device which is furthest from the operator.
- Referring now in detail to FIGS.1-5, in which like reference numerals identify similar or identical elements, a surgical stapling instrument or apparatus in accordance with a first embodiment of the disclosure is generally designated as 100.
Surgical stapling instrument 100 is an open gastrointestinal anastomosis type stapler and includes a first handle 102 having a jaw defining astaple cartridge 104 extending from a distal end thereof, and asecond handle 106 having a jaw defining astaple anvil 108 extending from a distal end thereof, such thatstaple cartridge 104 is substantially aligned withstaple anvil 108. - Turning now to FIGS. 2A, 2B and3, enlarged sections of the
staple cartridge 104 andstaple anvil 108 are shown, respectively. As seen in particular in FIGS. 2A and 3,staple cartridge 104 includes a pair of parallel spacedside walls 110 and 112 (see FIG. 3), a planarbottom wall 114, and a dual inclined top wall 116 (according to the orientation ofstaple cartridge 104 of FIG. 3) defining a working surface. Preferably dual inclinedtop wall 116 is inclined in a direction transverse to and away from the longitudinal axis. Dual inclinedtop wall 116 includes a first inclinedtop wall portion 118 inclined at an angle less than 90° relative to and towardfirst side wall 110, and a second inclinedtop wall portion 120 inclined at an angle less than 90° relative to and towardsecond side wall 112. Eachinclined wall portion terminal edge 118 a, 120 a, respectively, and an outer terminal edge 118 b, 120 b, respectively. In other words, innerterminal edge 118 a, 120 a are recessed intostaple cartridge 104 with respect to a plane defined by outer terminal edges 118 b, 120 b. Each of the first and second inclinedtop wall portions staple retention slots 124, extending substantially the entire length ofstaple cartridge 104, for receiving a plurality of fasteners (e.g., staples) and pushers therein (both of which are not shown). It is envisioned thatstaple cartridge 104 further includes a longitudinally orientedcentral passageway 122 extending the length thereof. - As seen in particular in FIGS. 2B and 3,
staple anvil 108 includes a pair of parallel spacedside walls top wall 130, and a dual inclined bottom wall 132 (according to the orientation ofstaple anvil 108 of FIG. 3) defining a working surface. Preferably, dualinclined bottom wall 132 is inclined in a direction transverse to the longitudinal axis. Dual inclinedbottom wall 132 includes a first inclinedbottom wall portion 134 inclined toward the longitudinal axis at an angle greater than 90° and less than 180° relative tofirst side wall 126, and a second inclinedbottom wall portion 136 inclined toward the longitudinal axis at an angle greater than 90° and less than 180° relative tosecond side wall 128.Staple anvil 108 further includes a longitudinally orientedpassageway 138 extending the length ofstaple anvil 108. Eachinclined wall portion terminal edge 134 a, 136 a, respectively, and an outer terminal edge 134 b, 136 b, respectively. In other words, innerterminal edges 118 a, 120 a are elevated out ofstaple anvil 108 with respect to a plane defined by outer terminal edges 134 b, 136 b. Each of the first and second inclinedbottom wall portions anvil depressions 140. Preferably,anvil depressions 140 ofstaple anvil 108 are in juxtaposed alignment withstaple retentions slots 124 ofstaple cartridge 104. - Preferably, the angle of inclination of first inclined
top wall portion 118 ofstaple cartridge 104 is complementary to the angle of inclination of first inclinedbottom wall portion 134 ofstaple anvil 108. Similarly, the angle of inclination of second inclinedtop wall portion 120 ofstaple cartridge 104 is complementary to the angle of inclination of second inclinedbottom wall portion 136 ofstaple anvil 108. In this manner, asstaple cartridge 104 is approximated relative tostaple anvil 108, a camming action takes place between the inclined surfaces (i.e., inclinedtop wall portions 118, 120) ofstaple cartridge 104 and the inclined surfaces (i.e., inclinedbottom wall portions 134, 136) ofstaple anvil 108. As such, whenstaple cartridge 104 is approximated relative to or withstaple anvil 108 with tissue “T” therebetween, alignment ofretention slots 124 withcorresponding anvil depressions 140 is enhanced. The configurations ofstaple cartridge 104 andstaple anvil 108 help alignretention slots 124 andanvil depressions 140 with one another asstaple cartridge 104 andstaple anvil 108 are brought into approximation or mating relationship with one another with tissue “T” and/or material to be stapled therebetween, and eachtime staple cartridge 104 is approximated withstaple anvil 108 with tissue “T” and/or material to be stapled therebetween. - “Approximated” herein means that the working surfaces of the anvil and cartridge are sufficiently close or near to each other and in contact with tissue, if there is tissue therebetween, that staples can be fired from the slots of the staple cartridge and properly formed in the depressions of the anvil. To be approximated the anvil and cartridge need not be, but preferably are, clamped or otherwise held together. Approximated may also apply to surgical stapling instruments which employ two-part fasteners wherein a first part of the two-part fastener is stored in a cartridge or like member and can be fired and properly joined to a second part of the two-part fastener disposed in an anvil or like member.
- While it has been described that the angle of inclination of the dual inclined
top wall 116 and the dualinclined bottom wall 132 are relative toparallel side walls staple cartridge 104 andstaple anvil 108, respectively, it is envisioned that the angle of inclination can be relative to any fixed reference. It is also envisioned that the angle of inclination of first and second inclinedtop wall portions staple cartridge 104 is inclined at an angle which is greater than 90° relative toside walls bottom wall portions staple anvil 108 is inclined at an angle less than 90° relative toside walls top wall portions bottom wall portions - As seen more clearly in FIG. 3, first and second inclined
top wall portions staple cartridge 104 are inclined such that the longitudinal edges of each of inclinedbottom wall portions longitudinal passageway 122, are closer to planarbottom wall 114 than are the longitudinal edges of the inclinedtop wall portions side walls top wall portions staple anvil 108 are inclined such that the longitudinal edges of each of inclinedbottom wall portions longitudinal passageway 138, are further away from topplanar wall 130 than are the longitudinal edges of inclinedtop wall portions side walls top wall portions planar surface 114 with first and second inclinedbottom wall portions planar surface 130, it is envisioned that first and second inclinedtop wall portions planar surface 114 while first and second inclinedbottom wall portions planar surface 130. - As will be described in greater detail below, it is contemplated that first and second
top wall portions bottom wall portions top wall portions top wall portions second wall portions second wall portions top wall portions - Turning now to FIGS. 4A, 4B and5, an enlarged perspective view of an
alternative staple cartridge 204 and analternative staple anvil 208 are shown.Staple cartridge 204 includes a pair of parallel spacedside walls bottom wall 214 and a top wall 216 (according to the orientation ofstaple cartridge 204 of FIG. 5) which is arcuate, preferably semicircular, in a direction transverse to a longitudinal axis thereof defining a working surface. Preferably,top wall 216 is concave. Concavetop wall 216 includes a pair of laterally spaced rows ofstaple retention slots 224 extending the entire length ofstaple cartridge 204.Staple anvil 208 includes a pair of parallel spacedside walls top wall 230 and a bottom wall 232 (according to the orientation ofstaple anvil 208 of FIG. 5) which is arcuate, preferably semi-circular, in a direction transverse to the longitudinal axis thereof defining a working surface. Preferably,bottom wall 232 is convex.Convex bottom wall 232 ofstaple anvil 208 includes a pair of laterally spaced rows ofstaple forming depressions 240. It is contemplated thattop wall 216 andbottom wall 232 can also be arcuate (e.g., semi-circular) in a direction longitudinally transverse to the longitudinal axis thereof. - Preferably, the radius of curvature of concave
top wall 216 ofstaple cartridge 204 is substantially equal to the radius of curvature of convexbottom wall 232 ofstaple anvil 208. In this manner, asstaple cartridge 204 andstaple anvil 208 are brought into approximation or are approximated with one another with tissue “T” therebetween, a camming action takes place between concavetop wall 216 ofstaple cartridge 204 and convexbottom wall 232 ofstaple anvil 208 to thereby help align the rows ofstaple retention slots 224 ofstaple cartridge 204 with the rows ofstaple forming depressions 240 ofstaple anvil 208. - As seen more clearly in FIG. 5, concave
top wall 216 ofstaple cartridge 204 is adapted to complement convexbottom wall 232 ofstaple anvil 208 therein upon approximation ofstaple cartridge 204 withstaple anvil 208 with tissue “T” therebetween. Accordingly, alignment ofstaple retention slots 224 ofcartridge 204 withstaple forming depressions 240 formed inanvil 208 is enhanced. While the convex surface is shown asbottom wall 232 ofstaple anvil 208 and concave surface is shown astop wall 216 ofstaple cartridge 204, it is envisioned that the convex surface can project from the top wall ofstaple cartridge 204 while concave surface can project into the bottom wall ofstaple anvil 208. - It is envisioned that
staple cartridge 204 and/orstaple anvil 208 include a longitudinally oriented central channel formed therethrough. It is envisioned that the central channel can accommodate a knife disposed within the staple cartridge and be slidable along the length of the central channel. - Reference can be made to commonly assigned U.S. Pat. No. 6,045,560 to McKean et al., U.S. Pat. No. 6,032,849 to Mastri et al., and U.S. Pat. No. 5,964,394 to Robertson, the entire contents of which are incorporated herein by reference, for a more detailed explanation of the operation of
surgical stapling instrument 100 and for approximating the staple cartridge with the staple anvil. - Turning now to FIGS.6-7B, there is disclosed a laparoscopic stapling apparatus (i.e., of the type such as an “Endo GIA™” surgical stapling apparatus available from United States Surgical, a division of Tyco Healthcare Group, LP, Norwalk, Conn.) generally shown as 300 and including a staple cartridge and staple anvil in accordance with the present disclosure. In general, the laparoscopic stapler includes a
handle 302, an operative tool 306 (i.e., end effector) and anelongated shaft 304 for interconnecting operative tool 306 to handle 302. In general, operative tool 306 is designed to approximate and then to staple and divide tissue “T” held therebetween. Accordingly, as seen in FIG. 7, operative tool 306 is a pair of opposed jaws including astaple anvil 308 and astaple cartridge 310 couplable, e.g., pivotally or transversely, to one another. - In particular, as seen in FIG. 7A,
staple anvil 308 is an elongated arm-like structure having a pair of inclinedlower surfaces 312 which project outwardly along and away from a central longitudinal axis “LA” ofstaple anvil 308. Preferably, inclinedlower surfaces 312 are inclined in a direction transverse to the longitudinal axis. Each ofinclined surfaces 312 ofstaple anvil 308 is provided with a plurality ofstaple forming depressions 314, preferably a pair of laterally spaced rows ofanvil depressions 140.Staple cartridge 310 is also an elongated arm-like member adapted to receive a removablestaple cartridge assembly 316 therein.Staple cartridge assembly 316 includes a pair of inclinedupper surfaces 318 projecting outwardly from and along a central longitudinal axis ofstaple cartridge assembly 316 and defining a working surface. Preferably, each of inclinedupper surfaces 318 is inclined in a direction transverse to the longitudinal axis. Each of inclinedupper surfaces 318 ofstaple cartridge assembly 316 includes a pair of laterally spaced rows ofstaple retention slots 320. The cooperation of the complementary working surfaces with tissue therebetween, helps to alignstaple retention slots 320 ofstaple cartridge assembly 316 withstaple forming depressions 314 ofstaple anvil 308 whenstaple cartridge assembly 316 is being or is approximated withstaple anvil 308 when the working surfaces have tissue “T” therebetween. - Inclined
lower surfaces 312 ofstaple anvil 308 have an angle of inclination which complements an angle of inclination of inclinedupper surfaces 318 ofstaple cartridge assembly 316. In this manner, whenstaple anvil 308 is, e.g., lowered or otherwise brought into contact with tissue “T” between the working surfaces ofanvil 308 andstaple cartridge assembly 316, a camming action between inclinedlower surfaces 312 and inclinedupper surfaces 318 helps alignstaple forming depressions 314 ofstaple anvil 308 withstaple retention slots 320 ofstaple cartridge assembly 316. While the angle of inclination ofupper surfaces 318 ofstaple cartridge assembly 316 have been shown as projecting inward and the angle of inclination oflower surfaces 312 ofstaple anvil 308 have been shown to project outward, it is envisioned that the angle of inclination ofsurfaces - Reference can be made to commonly assigned U.S. Pat. Nos. 6,330,965 and 6,241,139 to Milliman et al., the entire contents of which are incorporated herein by reference, for a more detailed explanation of the operation of surgical stapling apparatus300 and of the approximation of the staple cartridge with the staple anvil.
- FIG. 8 discloses an alternative stapling apparatus of the transverse anastomosis type for stapling a patient's mesentery or omentum (i.e., such as a “TA™” type surgical stapling apparatus available from United States Surgical, a division of Tyco Healthcare Group, LP, Norwalk, Conn.) generally designated as400 including a
handle 402, abarrel 404 extending from thehandle 402 and anarm 406 extending from the distal end of thebarrel 404. Thestapling device 400 further includes an end effector including astaple anvil 408 orthogonally affixed to a distal end ofarm 406 and astaple cartridge receiver 410 operatively coupled to the distal end ofbarrel 404 for holding a disposablestaple cartridge 412 thereon. - Turning now to FIGS. 9A and 9B,
staple cartridge 412 includes a pair ofinclined surfaces 414 projecting outwardly along a central longitudinal axis thereof. Preferably, each of the pair ofinclined surfaces 414 is inclined in a direction transverse to the longitudinal axis. Eachinclined surface 414 ofstaple cartridge 412 is provided with a pair of laterally spaced rows ofstaple retention slots 416.Staple anvil 408 includes a pair ofinclined surfaces 418 which project inwardly along a central longitudinal axis thereof and defining a working surface. Preferably, each of the pair ofinclined surfaces 418 is inclined in a direction transverse to the longitudinal axis. Eachinclined surface 418 ofstaple anvil 408 is provided with a pair of laterally spaced rows ofstaple forming depressions 420 formed therein. - Once again, the inclined pair of
surfaces 414 projecting fromstaple cartridge 412 have an angle of inclination which complements an angle of inclination of the pair ofinclined surfaces 418 ofstaple anvil 408. In this manner, whenstaple anvil 408 is being or is approximated relative tostaple cartridge 412, a camming action helps to alignstaple forming depressions 420 ofstaple anvil 408 to align withstaple retention slots 416 ofstaple cartridge 412. While the angle of inclination ofsurfaces 414 ofstaple cartridge 412 have been shown as projecting outward and the angle of inclination ofsurfaces 418 ofstaple anvil 408 have been shown to project inward, it is envisioned that angle of inclination ofsurfaces - Reference can be made to commonly assigned U.S. Pat. No. 5,964,394 to Robertson, the entire content of which is incorporated herein by reference, for a more detailed explanation of the operation of
surgical stapling apparatus 400 and of the approximation of the staple cartridge with the staple anvil. - Turning now to FIGS. 10, 11A,11B, 11C, 12A and 12B, there is shown an alternative surgical stapling apparatus of the end-to-end anastomosis type for performing surgical anastomotic stapling (i.e., an instrument such as an “EEA™” surgical stapling apparatus available from United States Surgical, a division of Tyco Healthcare Group, LP, Norwalk, Conn.), generally depicted as 500.
Surgical stapling apparatus 500 includes ahandle assembly 502 having at least one pivotableactuating handle member 503, and further includes advancingmeans 505. Extending fromhandle assembly 502, there is provided atubular body portion 504 which may be constructed so as to have a curved shape along its length.Tubular body portion 504 terminates in astaple pusher assembly 506 having acircular staple cartridge 518 including a pair of distally oriented spaced apart annular rows ofstaple retention slots 519 formed in a distal surface 521 (see FIG. 12A) thereof. As best seen in FIG. 12A,circular staple cartridge 518 preferably includes a pair of annular inclinedupstanding side walls 520 which are inclined at an obtuse angle relative todistal surface 521 ofstaple cartridge 518. -
Surgical stapling apparatus 500 further includes acircular anvil assembly 508 having an anvil head 509 and an anvil shaft 510 extending from a proximal end thereof and adapted to engage a trocar shaft 511 extending distally fromstaple cartridge 518. Anvil head 509 includes anannular anvil 512 disposed at a proximal end thereof, whereinanvil 512 includes a pair of laterally spaced rows of staple deforming depressions 514 (see FIG. 11B) formed circumferentially about asurface 513 ofanvil 512. Preferably, as best seen in FIG. 12A,anvil 512 further includes a pair of inclined annularupstanding side walls 512, namely, an inner wall 516 a and an outer wall 516 b, which side walls 516 a, 516 b are inclined at an obtuse angle relative to surface 513 ofanvil 512. - Preferably, the angle of inclination of side walls516 a, 516 b of
circular anvil 512 complement the angle of inclination ofside walls 520 of circularstaple cartridge 518. In this manner, whencircular anvil 512 is being or is approximated with or relative to circularstaple cartridge 518 with tissue “T” therebetween, a camming action takes place between tissue “T” and side walls 516 a, 516 b andside walls 520 thereby helping to bringstaple retention slots 519 into alignment withstaple deforming depressions 514. Preferably, side walls 516 a, 516 b have an angle of inclination which is greater than 90° and less than 180° relative to surface 513 ofanvil 512. - While it is shown that
circular anvil 512 includes a pair of annular side walls 516 a, 516 b having an obtuse angle of inclination relative toanvil surface 513 and circularstaple cartridge 518 includes a pair ofannular side walls 520 having an obtuse angle of inclination relative to surface 521 ofstaple cartridge 518, it is envisioned thatcircular anvil 512 may include a pair of annular side walls 516 a, 516 b having an obtuse angle of inclination relative to surface 513 ofanvil 512 while circularstaple cartridge 518 includes a pair of inclined upstandingannular side walls 520 having an obtuse angle of inclination relative todistal surface 521 ofstaple cartridge 518 which complements the angle of inclination of side walls 516 a, 516 b. - Turning now to FIG. 12B, an alternative cross-section of an anvil surface and a staple cartridge surface are generally shown as522 and 524, respectively.
Anvil surface 522 includes aconcave surface 526 for receiving aconvex surface 528 of circularstaple cartridge 524. Moreover, when arcuatestaple cartridge 524 with or is being or is approximated witharcuate anvil surface 522 with tissue “T” therebetween, a camming action takes place between tissue “T” andconcave surface 526 ofanvil surface 522 andconvex surface 528 ofstaple cartridge surface 524 thereby helping to bring staple retention slots 519 (not shown) of circularstaple cartridge 524 into alignment withstaple deforming depressions 514 ofcircular anvil surface 522. Once again, while it is shown that circularstaple cartridge 524 includes aconcave surface 528 andcircular anvil surface 522 includes aconvex surface 526, it is envisioned that circularstaple cartridge 524 can have the convex surface while the circular anvil can have the concave surface. - As seen in FIGS. 12C and 12D, it is envisioned that
anvil 512 is provided either with an inclined inner wall 516 a extending from an inner edge thereof (see FIG. 12D) or an inclined outer wall 516 b extending from an outer edge thereof (see FIG. 12C). Since inner wall 516 a and outer wall 516 b are annular, a single inclined wall (i.e., either inner wall 516 a or outer wall 516 b) is all that is needed in order to properly alignstaple cartridge 518 withstaple anvil 512 upon their approximation to one another. In particular, the camming action between tissue “T” and inner wall 516 a or outer wall 516 b ofanvil 512 with correspondingannular side wall 520 ofstaple cartridge 518 helps to bringstaple deforming depressions 514 into alignment withstaple retention slots 519. - It is further envisioned that
anvil 512 can include asurface 513 having a pair of inclined surface portions (not shown) terminating in a central ridge (not shown) and astaple cartridge 518 can include asurface 521 having a pair of inclined surface portions (not shown) terminating in a central valley (not shown) (i.e., similar to the configuration ofstaple cartridge 104 of staple anvil 108). - In yet another embodiment, as seen in FIGS. 12E and 12F, it is envisioned that
anvil 512 is substantially conical and includes asurface 513 which is angled to have aninner edge 513 a which is either recessed (see FIG. 12E) or elevated (see FIG. 12F) relative to an outer edge 513 b andstaple cartridge 518 has asurface 521 which complements the angle of inclination ofsurface 513 ofanvil 512. - It should be appreciated that in each of the above disclosed embodiments, upon approximation of the opposed anvil and cartridge halves of the particular embodiment with tissue “T” therebetween, there is an enhanced opportunity for each of the staple deforming depressions formed in the surface of the anvil to be transversely and longitudinally aligned with a staple retention slot formed in staple cartridge to enhance proper staple formation. The angle at which the staples are oriented relative to the cartridge is determined, e.g., by the formation and disposition of the staple pockets within the cartridge in any given embodiment. In conventional surgical stapling apparatus, for example, the staple pockets are typically oriented to eject the staples perpendicular to the surface of the cartridge. In the embodiments disclosed herein, the staple retention slots may likewise be formed to eject the staples perpendicular to the surface of the staple cartridge or in the case of a curved surface perpendicular to a tangent of the surface of the staple cartridge at the point along the surface where the staple retention slot opening lies. In such curved surface embodiments, the pusher member, which travels longitudinally to cam individual staple pushers contained in the staple retention slots, can have a camming surface which matches the cross-sectional profile of the cartridge surface where the staples are being ejected in order to apply the force necessary to effectively form the staples against the opposed anvil surfaces.
- Reference can be made to commonly assigned U.S. Pat. No. 5,915,616 to Viola et al., the entire content of which is incorporated herein by reference, for a more detailed explanation of the operation of
surgical stapling apparatus 500 and of mating and/or approximating of a staple cartridge with a staple anvil. - Turning now to FIG. 13, an alternative embodiment of a staple cartridge and a staple anvil is shown generally as602 and 606, respectively. As seen in FIG. 13,
staple anvil 602 includes a wave-like or undulatingtop surface 604 extending longitudinally along the length thereof whilestaple cartridge 606 includes a wave-like or undulatingbottom surface 608 extending longitudinally along a length thereof. Preferably, the cross-sectional profile of undulatingtop surface 604 complements the cross-sectional profile of juxtaposed undulatingbottom surface 608. In this manner, undulatingbottom surface 608 and undulatingtop surface 604 cooperate with one another upon approximation ofcartridge 606 withanvil 602 to thereby longitudinally align staple deforming depressions (not shown) formed inanvil 602 with staple retention slots (not shown) formed incartridge 606. It is envisioned that the transverse alignment configurations described above can be combined with the longitudinal alignment configuration described above in order to help align the staple anvil with the staple cartridge in a longitudinal direction. - It is contemplated that, in an alternate embodiment, that the staple anvil includes a wavelike or undulating topographical surface extending in both a transverse and a longitudinal direction and the staple cartridge include a wave-like or undulating topographical surface, extending in both a transverse and a longitudinal direction, wherein the undulating surface of the staple anvil complements the undulating surface of the staple cartridge. In this manner, when the staple anvil and the staple cartridge are approximated with or relative to one another, the staple deforming depressions and the staple retention slots are substantially transversely and longitudinally aligned with one another.
- Turning now to FIGS. 14 and 15, the distal end portions of a staple anvil and a staple cartridge, in accordance with alternative embodiments of the present disclosure, are shown generally as702 and 706, respectively.
- As seen in FIG. 14,
staple cartridge 706 includes a recessedsurface 708 formed as part of the tissue contacting surface or working surface ofstaple cartridge 706. Recessed workingsurface 708 includes a distal end portion 708 a extending at an angle into staple cartridge 706 (e.g., in the form of a ramp) and a more proximal portion 708 b extending longitudinally along a length ofstaple cartridge 706. It is contemplated that proximal portion 708 b can have, for example, a V-shaped, rectangular, arcuate, undulating or other suitable cross-sectional profile.Staple anvil 702 includes a projecting workingsurface 704 extending from the tissue contacting or working surface ofstaple anvil 702 and in juxtaposition relative to recessedsurface 708 ofstaple cartridge 706. Projectingsurface 704 is shaped and sized to complement the size and shape of recessed workingsurface 708 and preferably includes adistal end portion 704 a extending at an angle out of staple anvil 702 (e.g., in the form of a ramp) and a more proximal portion 704 b extending longitudinally along a length ofstaple anvil 702. - As seen in FIG. 15,
staple cartridge 706 includes a recessedsurface 708′ formed in the tissue contacting side ofstaple cartridge 706. Recessedsurface 708′ preferably has an elongate concave topographical profile including a concave leading distal end portion 708 a′ and a more proximal portion 708 b′ extending longitudinally along a length ofstaple cartridge 706.Staple anvil 702 includes a projectingsurface 704′ as or extending from the tissue contacting or working surfaces ofstaple anvil 702 and in juxtaposition relative to recessedsurface 708′ ofstaple cartridge 706. Projectingsurface 704′ is shaped and sized to complement the size and shape of recessedsurface 708′ and preferably includes a convex leadingdistal end portion 704 a′ extending into a more proximal portion 704 b′ extending longitudinally along the length ofstaple anvil 702. - As seen in FIGS. 16 and 17, working
surfaces staple cartridge 706′ andstaple anvil 702′, respectively, need not be parallel to but can be at an angle relative to the longitudinal axis “LA” of the end effector, thesurgical stapling instrument 100 or the respective anvil and/or cartridge. For example, as seen in FIG. 16, the angles of workingsurfaces staple cartridge 706′ can be generally declining from the distal end or distal end portions ofstaple cartridge 706′ andstaple anvil 702′, or as shown in FIG. 17, workingsurfaces 710′, 712′ can be declining toward the distal end or distal end portions of the respective anvil and cartridge. - It is further contemplated that, in another alternate embodiment, the staple anvil can be provided with a longitudinally running row of detents or dimples formed in the surface of the staple anvil, preferably near at least one longitudinal side edge thereof while the staple cartridge is preferably provided with a longitudinally running row of nubs or projections extending from the surface of the staple cartridge. Accordingly, when the staple anvil is being or is approximated with or relative to the staple cartridge, the nubs of the staple cartridge will force the interstitial tissue into the detents of the staple anvil and such will help to both transversely and longitudinally align the staple deforming depressions with the staple retention slots. It is further envisioned that the nubs of the staple cartridge could be replaced with pins or needles which would penetrate the tissue disposed between the staple anvil and the staple cartridge and then enter the detents or dimples of the staple anvil.
- While alignment configurations may extend the entire length and width of the staple anvils and staple cartridges described above, it is envisioned that such alignment features need only be placed or occur at pre-selected locations along a or the length and/or along a or the width, or a portion of the end effector or working surface(s) in order provide a surgical stapling apparatus which helps to align itself upon each mating and/or approximation of the staple anvil with the staple cartridge.
- Surgical stapling apparatus disclosed above include a staple anvil or a staple cartridge having a surface with a first shaped topography (i.e., trapezoidal, arcuate, triangular, undulating, etc.) and the other of the staple anvil or staple cartridge having a surface with a second shaped topography which is complementary to the first shaped topography. Accordingly, when the staple cartridge and the staple anvil are being or are approximated with or relative to one another with tissue “T” therebetween, the first shaped topographical surface cooperates with the second shaped topographical surface to help align the staple anvil and the staple cartridge in a transverse and/or longitudinal direction.
- By providing a surgical stapling apparatus including a staple anvil having a shaped working surface together with a staple cartridge having a shaped working surface, which shaped working surfaces complement each other, the staple anvil and the staple cartridge are urged to align with one another each time the staple anvil is brought into approximation with the staple cartridge, thereby also enhancing alignment of staple deforming depressions formed in the staple anvil, with the staple retention slots formed in the staple cartridge. Such configured anvils and cartridges may be suitably formed from suitable materials other than steel which are less expensive and easier to form yet which may achieve the high degree of tolerance for alignment between the staple retention slots and the staple deforming depressions.
- Where it is stated herein that there is tissue between a staple cartridge and a staple anvil, it is to be understood that with in lieu of the tissue there could be or also be a suitable surgical material, for a non-limiting example, a Pledget™ material, therebetween.
- In accordance with the present disclosure, it is understood that the working surfaces of the surgical staplers disclosed herein can be approximated in any number of methods as are known by those skilled in the art without departing from the scope and/or breath of the present disclosure.
- It will be understood that various modifications may be made to the embodiments disclosed herein. Therefore, the above description should not be construed as limiting, but merely as an exemplification of preferred embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.
Claims (36)
Priority Applications (10)
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US10/411,686 US7070083B2 (en) | 2002-04-11 | 2003-04-11 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US11/113,928 US8800840B2 (en) | 2002-04-11 | 2005-04-25 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US11/999,710 US7828188B2 (en) | 2002-04-11 | 2007-12-06 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US11/999,661 US8292153B2 (en) | 2002-04-11 | 2007-12-06 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US12/008,298 US8393513B2 (en) | 2002-04-11 | 2008-01-09 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US13/762,626 US8544712B2 (en) | 2002-04-11 | 2013-02-08 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US14/040,778 US20140027493A1 (en) | 2002-04-11 | 2013-09-30 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US15/160,375 US10307161B2 (en) | 2002-04-11 | 2016-05-20 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US15/166,967 US10292706B2 (en) | 2002-04-11 | 2016-05-27 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US16/414,821 US11160554B2 (en) | 2002-04-11 | 2019-05-17 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
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US10/411,686 US7070083B2 (en) | 2002-04-11 | 2003-04-11 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
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US11/113,928 Expired - Fee Related US8800840B2 (en) | 2002-04-11 | 2005-04-25 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US11/999,661 Active 2024-06-21 US8292153B2 (en) | 2002-04-11 | 2007-12-06 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US11/999,710 Expired - Fee Related US7828188B2 (en) | 2002-04-11 | 2007-12-06 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US12/008,298 Active 2024-06-28 US8393513B2 (en) | 2002-04-11 | 2008-01-09 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US13/762,626 Expired - Lifetime US8544712B2 (en) | 2002-04-11 | 2013-02-08 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US14/040,778 Abandoned US20140027493A1 (en) | 2002-04-11 | 2013-09-30 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US15/160,375 Expired - Fee Related US10307161B2 (en) | 2002-04-11 | 2016-05-20 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US15/166,967 Expired - Fee Related US10292706B2 (en) | 2002-04-11 | 2016-05-27 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US16/414,821 Expired - Lifetime US11160554B2 (en) | 2002-04-11 | 2019-05-17 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
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US11/113,928 Expired - Fee Related US8800840B2 (en) | 2002-04-11 | 2005-04-25 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US11/999,661 Active 2024-06-21 US8292153B2 (en) | 2002-04-11 | 2007-12-06 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US11/999,710 Expired - Fee Related US7828188B2 (en) | 2002-04-11 | 2007-12-06 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US12/008,298 Active 2024-06-28 US8393513B2 (en) | 2002-04-11 | 2008-01-09 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US13/762,626 Expired - Lifetime US8544712B2 (en) | 2002-04-11 | 2013-02-08 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US14/040,778 Abandoned US20140027493A1 (en) | 2002-04-11 | 2013-09-30 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US15/160,375 Expired - Fee Related US10307161B2 (en) | 2002-04-11 | 2016-05-20 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US15/166,967 Expired - Fee Related US10292706B2 (en) | 2002-04-11 | 2016-05-27 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
US16/414,821 Expired - Lifetime US11160554B2 (en) | 2002-04-11 | 2019-05-17 | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
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US11160554B2 (en) | 2021-11-02 |
US7828188B2 (en) | 2010-11-09 |
US8393513B2 (en) | 2013-03-12 |
US8544712B2 (en) | 2013-10-01 |
US20130146640A1 (en) | 2013-06-13 |
US20190269408A1 (en) | 2019-09-05 |
WO2003086206A1 (en) | 2003-10-23 |
US7070083B2 (en) | 2006-07-04 |
AU2003226050A1 (en) | 2003-10-27 |
US20080087706A1 (en) | 2008-04-17 |
US20080087707A1 (en) | 2008-04-17 |
US20160278779A1 (en) | 2016-09-29 |
US20080110960A1 (en) | 2008-05-15 |
US20050189397A1 (en) | 2005-09-01 |
US10292706B2 (en) | 2019-05-21 |
WO2003086206A9 (en) | 2004-04-22 |
US20160270790A1 (en) | 2016-09-22 |
US10307161B2 (en) | 2019-06-04 |
US8292153B2 (en) | 2012-10-23 |
US8800840B2 (en) | 2014-08-12 |
US20140027493A1 (en) | 2014-01-30 |
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